In-depth look into Medicare Advantage Plans and the Risk for Double Damages - CLM Magazine
We are thrilled to share with you an in-depth and timely piece featured in this month's CLM Magazine, titled Medicare Advantage Plan Enrollment Gains Momentum; So Does the Risk for Double Damages.
Penned by Beth Hostetler, Director of Medicare Services at Albertsons, and Heather Sanderson, President of Sanderson Firm PLLC, this informative article delves into the intricate details of Medicare Advantage Plans (MAPs) and the challenges they pose in terms of recovery rights for conditional payments and potential double damages under the Medicare Secondary Payer Act.
The authors highlight the growing popularity of MAPs, with more than 30 million Americans enrolled as of January 2023. They also discuss the recent spike in litigation from MAPs seeking to establish a firm right to double damages, a concerning trend for any party settling with a Medicare beneficiary.
Alongside the in-depth analysis, Hostetler and Sanderson present valuable insights into how MAPs tie into Medicare Secondary Payer (MSP) regulations, the implications of the PAID Act, and how primary payers should approach conditional payment notices.
This article emphasizes the crucial need for risk management best practices and well-defined Medicare compliance programs to handle the rising complexities of MSP compliance. Additionally, it calls attention to the importance of data integrity in Medicare Section 111 reporting and the need for proactive measures for conditional payment resolution.
Whether you're a risk manager, a healthcare professional, or simply interested in the ongoing changes in Medicare policy, this article provides a comprehensive overview of the current landscape of MAPs and offers practical advice on managing these evolving challenges.
Take some time to read this insightful piece in the CLM June 2023 issue, available on page 12. Here is the direct link to the magazine: CLM June 2023
Stay informed and ahead of the curve with the latest insights and updates in the world of Medicare and risk management.
